Effectiveness of a brief advance directive intervention in primary care: a randomized clinical trial |
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| Authors: | Yolanda Rando-Matos Toni Vives-Argilagós Estrella Rodero-Pérez Lluís Solsona-Díaz José Luis Ballvé-Moreno Noemí Moreno-Farrés Rosa Sorando-Alastruey Raquel Adroer-Martori Núria Sanfeliu-Soto Jesús Almeda-Ortega |
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| Affiliation: | 1. Centre d’Atenció Primària Florida Nord, Direcció d’Atenció Primària Costa de Ponent, Catalan Health Institute (ICS), L’Hospitalet de Llobregat, Barcelona, Spain;2. University Institute in Primary Care Research Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain;3. Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain;4. Universitat de Barcelona, Barcelona, Spain;5. Unitat de Suport a la Recerca Costa de Ponent, Direcció d’Atenció Primària Costa de Ponent, Catalan Health Institute (ICS), Cornellà de Llobregat, Barcelona, Spain;1. University of Southern Queensland, Institute for Resilient Regions, Centre for Health Research, Springfield QLD 4300, Australia;2. Ghent University, Department of Movement and Sports Sciences, B-9000 Ghent, Belgium;3. Ghent University, Department of Public Health and Primary Care, B-9000 Ghent, Belgium;4. Flanders Institute for Healthy Living, B-1020 Brussels, Belgium;1. National Institute of Physical Education of Catalonia (INEFC), Campus Lleida, Catalonia, Spain;2. Complex systems and sport research group, Spain |
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| Abstract: | ![]()
ObjectiveTo measure the effectiveness of a brief intervention aimed at increasing interest in and use of advanced directives (AD) among primary care patients.MethodsRandomized controlled trial. In the intervention arm, patients were given brief oral information and a leaflet on AD by General Practitioners (GPs), in the control group were briefly informed about the study’s purpose. Outcome variables were the proportion of patients who expressed interest in AD and those who completed one. Covariates were sex, age, education, race, Charlson comorbidity index (CCI), religion, and possession of financial will.ResultsOverall, 332 patients were recruited; 58 in the intervention and 36 in the control group expressed interest in AD (p = 0.033) and 18 (5.4 %) made an AD (nine in each group). Variables associated with interest were Caucasian race (odds ratio [OR], 1.88), the intervention (OR, 1.86), and CCI extreme scores (OR, 0.36). Variables associated with AD completion were primary education/no schooling (OR, 5.69) and fewer children (OR, 0.57).ConclusionsA brief oral and written intervention delivered by GP significantly increased interest in AD and achieved a completion rate of 5.4 %, without differences with the control group.Practice ImplicationsAD interventions should focus on individuals already likely to be motivated. |
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| Keywords: | Advanced care planning Advance directives Adult population Living will Primary care Randomized clinical trial |
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